Frequency, characteristics, and outcome of PTLD after allo-SCT: A multicenter study from the Spanish group of blood and marrow transplantation (GETH)

Irene García-Cadenas, Lucrecia Yáñez, Isidro Jarque, Rodrigo Martino, Jose Antonio Pérez-Simón, David Valcárcel, Jaime Sanz, Arantxa Bermúdez, Cristina Muñoz, Cristina Calderón-Cabrera, Estefania García, Laura Alonso, Maria Suárez-Lledó, Marta González Vicent, Inmaculada Heras, Mª Cruz Viguria, Montserrat Batlle, Lourdes Vázquez, Javier López, Carlos Solano

    Research output: Contribution to journalArticleResearch

    4 Citations (Scopus)

    Abstract

    © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Post-transplant lymphoproliferative disorder (PTLD) is an infrequent complication of allogeneic stem cell transplant (allo-SCT). Aims: To estimate the frequency and management of PTLD in Spain and to identify prognostic factors influencing outcomes. Methods: Multicenter, retrospective analysis of allo-SCT performed in 14 transplant units over a 15-year period. Results: 102 PTLD were diagnosed among 12 641 allo-SCT, leading to an estimated frequency of 0.8%. PTLD was diagnosed at a median of 106 days after SCT. Eighty-seven cases (85%) were diagnosed between 2007 and 2013. At diagnosis, 22% and 17% of the patients had gastrointestinal tract and CNS involvement. Eighty-seven (85%) received rituximab treatment, alone or in combination with immunosuppression reduction, with an ORR of 50.6%. With a median follow-up for survivors of 58 months, the 2-year overall survival (OS) was 33% and the PTLD-related mortality 45%. Age ≥ 40 years, malignant underlying disease, non-response to rituximab, and severe thrombocytopenia or lymphocytopenia at PTLD diagnosis were associated with worse overall survival. Conclusions: Only a small proportion of allografted patients were diagnosed a PTLD. Its clinical course was highly aggressive, and prognosis poor, especially in those failing rituximab. The prognostic impact found of the platelet, and lymphocyte count at diagnosis requires further confirmation.
    Original languageEnglish
    Pages (from-to)465-471
    JournalEuropean Journal of Haematology
    Volume102
    DOIs
    Publication statusPublished - 1 Jun 2019

    Keywords

    • allo-SCT
    • EBV
    • infection
    • PTLD
    • rituximab

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